Back on the Block Minority Accelerator Application

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Our minority business accelerator is designed to accelerate the development of minority and women-owned businesses. Our program helps minority businesses get access to tools, resources, networking, and capital to grow.

To be considered your small business needs to be generating at least $35,000 in annual revenue or have traction with a product or service in the market.

Tuition for this program $7500.00+

It is FREE to you.

What we require is a FULL agreement of your time and commitment to FULLY participate and be present.

The accelerator is a one year commitment. The start date will be ***May 24th***. The first 14 - 18 weeks you will need to commit to meeting one night a week for 2 -3 hours As well as put in 10 -15 hours a week working on your business model development.

***The application deadline is Friday, April 30th at 5pm ***

How did you find out about the Minority Business Accelerator? *

First Name; Last Name *

Email *

Company *

Is this a Minority or Women Owned Business? *

Yes, American Indian or Alaska Native

Yes, Asian

Yes, Black or African American

Yes, Native Hawaaina or Other Pacific Islander

Yes, Hispanic, Latino or Spanish Origin

Yes, Women-Owned

Other:

Is the business HUB, DBE, MWBE Certified? *

HUB

DBE

MWBE

Not Yet Certififed

Primary Contact: Name and Title *

Mailing Address *

Phone Number *

Business Website *

Social Media Handle(s) Facebook, Twitter, Instagram, Linkedin, etc *

Entity Type *

Sole Proprietor

LLC

SCorp

Other:

Required

What month/year did you start/purchase your business? *

Number of full-time employees? *

Number of part-time employees? *

Last years estimated annual revenue? *

Have you received funding in the pass? *

Yes, less than $10K

Yes, between $10K - $25K

Yes, between $25K - $50K

Yes, $50K - $100K

Yes, $100K plus

Other

If you've received funding, what was your funding source(s)? *

Loan

Government funding

Private funding

Corporate funding

Line of Credit

Required

Provide a brief description of your business. *

Describe your projected growth and potential economic impact of the business over the next three to five years. *

Describe the current stage of the business and types of resources needed to grow the business? *

Describe what you would like to get from participation in the Genesis Block Back on the Block Accelerator. *

This program is free to you the participant, however it requires a commitment from you. How will you make time to FULLY participate? *

You will need to forward the following documents to info@genesisblockilm.com: 1) A 12 month business plan. 2)A business cash flow projection for the next three years. Will you be able to? *

Yes

If no to the above question please explain why not. *

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